Abstract

PIP:

The world today is faced with difficult challenges in health. The development model which pursues economic growth of the rich, regardless of human and environment costs, has reversed generations of progress toward a social order that had begun to envisage "health for all" as a basic human right. The western medical model introduced in the days of colonialism had benefited only the dominating White colonists; local peasantry and working class were mostly excluded. In the 19th century, a social consciousness evolved which recognized that society collectively had a responsibility to assure that the basic needs of all people are met. However, health services were still insufficient. From the 1950s through the 1970s, the enormous unmet health needs of vast numbers of people gave rise to a variety of grassroots, popular alternatives to the elitist Western medical model. This paper offers insights into the various people-centered initiatives designed to meet the health needs of the poor. It also discusses the Alma Ata Declaration of 1978. In this declaration, leaders of nations committed themselves to working toward "Health for All by the Year 2000", through a revolutionary strategy called Primary Health Care (PHC). The three major assaults on PHC were identified and discussed; they are 1) selective primary health care in the late 1970s, 2) structural adjustment and user financing in the 1980s, and 3) takeover by the World Bank of Third World health policy planning in the 1990s.